Ophthalmological patient interface device

ABSTRACT

An ophthalmological patient interface device ( 27 ), for application onto an eye ( 3 ) during treatment of the eye ( 3 ), comprises a coupling part ( 21 ) for attaching mechanically the ophthalmological patient interface device ( 27 ) to an optical projection system ( 20 ) of an ophthalmological apparatus ( 1 ), and a fastening device ( 271 ) for fastening the ophthalmological patient interface device ( 27 ) to the eye ( 3 ). The ophthalmological patient interface device ( 27 ) further comprises a mirror system ( 275 ) arranged downstream from the optical projection system ( 20 ), when the ophthalmological patient interface device ( 27 ) is attached mechanically to the optical projection system ( 20 ), and having at least one mirroring surface arranged at an angle with respect to a projection axis of the optical projection system ( 20 ), such that a laser beam (L 3 ) projected by the optical projection system ( 20 ) is deflected by the mirror system ( 275 ).

The present application claims benefit of and priority to U.S.Provisional Patent Application Ser. No. 61/604,149 filed Feb. 28, 2012entitled Apparatus for Treating Eye Tissue with Laser Pulses, the entirecontent of which is hereby incorporated by reference herein.

BACKGROUND

1. Field of the Disclosure

The present invention relates to an ophthalmological patient interfacedevice for application onto an eye during treatment of the eye.Specifically, the present invention relates to an ophthalmologicalpatient interface device comprising a coupling part configured to attachmechanically the ophthalmological patient interface device to an opticalprojection system of an ophthalmological apparatus and a fasteningdevice configured to fasten the ophthalmological patient interfacedevice to the eye, and to an ophthalmological apparatus comprising anoptical projection system for projecting a laser beam into eye tissuefor treatment of the eye and a coupling part configured to attachmechanically the optical projection system to the ophthalmologicalpatient interface device.

2. Related Art

EP 1731120 describes an ophthalmological apparatus comprising a basestation with a light source for generating laser pulses, and anapplication head which can be mounted on an eye having a light projectorfor the focused projection of the laser pulses for punctiform breakdownof eye tissue. The application head is attached to an articulatedsupport which is connected moveably to the base station. Theophthalmological apparatus further comprises an optical transmissionsystem for transmitting the laser pulses from the base station throughthe support arm to the light projector. EP 1731120 further discloses atransparent contact body with fastening means for fixing the contactbody to the eye of a patient. The contact body can be mounted removablyto the light projector of the ophthalmological apparatus, e.g. by meansof a screw lock or a snap lock, and can be disposed or sterilized afteruse on a patient. The contact body makes it possible to place the corneain a defined position with respect to the light projector so that a flapof the cornea may be cut equidistantly to the exterior surface of thecornea, for example. On the other hand, the mechanical deformation ofthe cornea caused by placing the contact body on the cornea may produceundesirable side effects such as corneal folds that disturb the focusbehind the posterior surface of the cornea.

US 2010/0274228 describe a functional element that can be coupled to theeye by means of a suction ring. The functional element can be formed inthe fashion of a container which can receive a liquid that is locatedduring operation between the cornea of the eye and a lens. Thefunctional element of US 2010/0274228 represents a liquid eye interfacewhich does not cause mechanical deformations of the cornea that producecorneal folds. On the other hand, the liquid interface of US2010/0274228 does not place the cornea in a sufficiently definedposition with respect to a projection lens so that accurate corneal cutscan only be made by using complex imaging feedback systems and real-timeposition control during operation, while some corneal cuts cannot beperformed with sufficient accuracy at all.

SUMMARY

It is an object of this invention to provide an improvedophthalmological patient interface device for application onto an eyeduring treatment of the eye. Particularly, it is an object of thisinvention to provide an improved ophthalmological patient interfacedevice for application onto an eye during treatment of the eye by anophthalmological apparatus projecting a laser beam into eye tissue.

According to the present invention, these objects are achieved throughthe features of the independent claims. In addition, furtheradvantageous embodiments follow from the dependent claims and thedescription.

An ophthalmological patient interface device for application onto an eyeduring treatment of the eye comprises a coupling part configured toattach mechanically the ophthalmological patient interface device to anoptical projection system of an ophthalmological apparatus, and afastening element configured to fasten the ophthalmological patientinterface device to the eye.

According to the present invention, the above-mentioned objects areparticularly achieved in that the ophthalmological patient interfacedevice further comprises a mirror system arranged downstream from theoptical projection system, when the ophthalmological patient interfacedevice is attached mechanically to the optical projection system, andhaving at least one mirroring surface arranged at an angle with respectto a projection axis of the optical projection system such that a laserbeam projected by the optical projection system is deflected by themirror system. Providing the ophthalmological patient interface devicewith a mirror system which is positioned downstream from the opticalprojection system, when the ophthalmological patient interface device isattached to the optical projection system, has the advantage that theprojected laser beam can be redirected flexibly by the ophthalmologicalpatient interface device. Accordingly, the mirror system of theophthalmological patient interface device makes it possible to extendflexibly and easily the treatment area of an ophthalmological apparatusor add new treatment procedures, respectively, which would otherwise notbe possible with conventional configurations.

In an embodiment, the mirror system comprises more than one mirror whichare arranged in a sequence such that the laser beam projected by theoptical projection system is guided by the mirror system behind selectedstructures of the eye, without traversing the selected structures of theeye, the selected structures of the eye including the Iris, the anteriorspace, the limbus, and/or the sclera.

In a further embodiment, the ophthalmological patient interface devicefurther comprises a wall extending from the fastening element to thecoupling part and encompassing a hollow space, and the mirror system isarranged in the hollow space. For example, the wall has an inlet forfilling a liquid or gel into the hollow space when the ophthalmologicalpatient interface device is applied on the eye.

In addition to the ophthalmological patient interface device, thepresent invention also relates to an ophthalmological apparatus, whichcomprises an optical projection system for projecting a laser beam intoeye tissue for treatment of the eye, a coupling part configured toattach mechanically the optical projection system to an ophthalmologicalpatient interface device configured to fasten the optical projectionsystem to the eye, and a mirror system which is attached to the opticalprojection system and arranged downstream from the optical projectionsystem, and has at least one mirroring surface arranged at an angle withrespect to a projection axis of the optical projection system such thatthe laser beam projected by the optical projection system is deflectedby the mirror system.

In an embodiment, the mirror system of the ophthalmological apparatus isarranged at least partly in an opening of the ophthalmological patientinterface device, when the ophthalmological patient interface device isattached mechanically to the optical projection system.

In another embodiment, the ophthalmological apparatus further comprisesa wall extending from the optical projection system to the coupling partand encompassing a hollow space, the mirror system being arranged atleast partly in the hollow space.

In a further embodiment, the mirror system of the ophthalmologicalpatient interface device or of the ophthalmological apparatus,respectively, comprises more than one mirror which are arranged in asequence such that the laser beam projected by the optical projectionsystem is guided by the mirror system to impinge the eye tissue at adifferent angle than the projection axis of the optical projectionsystem.

In an embodiment, the mirror system of the ophthalmological patientinterface device or of the ophthalmological apparatus, respectively,comprises more than one mirror which are arranged in a sequence suchthat the laser beam projected by the optical projection system is guidedby the mirror system to impinge the eye tissue at a different locationthan the projection axis of the optical projection system.

In a further embodiment, the mirror system of the ophthalmologicalpatient interface device or of the ophthalmological apparatus,respectively, comprises at least one mirroring surface which isrotatable about the projection axis of the optical projection system.

In an embodiment, the mirror system of the ophthalmological patientinterface device or of the ophthalmological apparatus, respectively,comprises at least one mirror with an adjustable deflection angle.

In a further embodiment, the mirror system of the ophthalmologicalpatient interface device or of the ophthalmological apparatus,respectively, comprises more than one mirror which are arranged in asequence such that the laser beam projected by the optical projectionsystem is guided by the mirror system behind selected structures of theeye, without traversing the selected structures of the eye, the selectedstructures of the eye including the Iris, the anterior space, thelimbus, and/or the sclera.

In an embodiment, the ophthalmological apparatus further comprises adetector configured to determine a device identifier associated with theophthalmological patient interface device, and a control moduleconfigured to control the ophthalmological apparatus using the deviceidentifier. For example, the device identifier indicates a type of theophthalmological patient interface device comprising a mirror, aposition of the mirror, and/or an angular arrangement of the mirror.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be explained in more detail, by way ofexample, with reference to the drawings in which:

FIG. 1: shows a block diagram illustrating schematically anophthalmological apparatus for treating eye tissue with laser pulses,the apparatus comprising an optical projection system with anophthalmological patient interface device attached thereon.

FIG. 2: shows a block diagram illustrating schematically theophthalmological apparatus of FIG. 1 comprising a base station with alaser source and a support arm with the optical projection system andthe ophthalmological patient interface device connected thereto.

FIG. 3: shows a block diagram illustrating schematically theophthalmological apparatus of FIG. 1 comprising a base station with alaser source and an articulated support arm for connecting the opticalprojection system and the ophthalmological patient interface device.

FIG. 4: shows a block diagram illustrating schematically theophthalmological apparatus of FIG. 3 with a different positionaladjustment of the articulated arm.

FIG. 5: shows a block diagram illustrating schematically theophthalmological apparatus of FIG. 1 with an ophthalmological patientinterface device having a ring-shaped contact part and a hollow space.

FIG. 6: shows a block diagram illustrating schematically theophthalmological patient interface device with the ring-shaped contactpart and hollow space.

FIG. 7: shows a block diagram illustrating schematically theophthalmological patient interface device with a mirror system arrangedin the hollow space.

FIG. 8: shows a block diagram illustrating schematically theophthalmological apparatus of FIG. 1 with an ophthalmological patientinterface device having a ring-shaped contact part, a hollow space, anda mirror system arranged in the hollow space.

FIG. 9: shows a schematic diagram of profiles of a pulsed laser beam indifferent states where the pulsed laser beam is projected on differentprojection surfaces and focused on one of the projection surfaces with adefined spot size.

DETAILED DESCRIPTION OF THE EMBODIMENTS

In FIGS. 1, 2, 3, 4, 5 and 8, reference numeral 1 refers to anophthalmological apparatus for treating eye tissue 30 with laser pulsesP. As is illustrated schematically in FIGS. 1, 2, 3, 4, 5 and 8, theophthalmological apparatus 1 comprises a laser source 100 and a controlmodule 14. Depending on the embodiment, the laser source 100 and thecontrol module 14 are arranged in a base station 10, as shown in FIGS.2, 3, 4, for example. The laser source 100 is configured to generate apulsed laser beam L, L′, L*, L1, L2, L3 (see FIG. 5, 8 or 9), e.g. abeam of femtosecond laser pulses P. In an embodiment, the laser source100 is configured to generate a pulsed laser beam L, L′, L*, L1, L2, L3with a selectable wavelength in the IR-A-infrared range, theIR-B-infrared range, and/or the UVA-ultra violet range. Depending on theembodiment, the laser source 100 includes one or more lasers and/or afrequency modulation module for generating the laser beam L, L′, L*, L1,L2, L3 with alternate wavelengths. For example, the control module 14comprises a processor with data and program memory, the program memoryhaving stored therein programmed software modules with computer programcode for controlling the processor. One skilled in the art willunderstand that there are various alternatives for implementing thecontrol module 14 by way of hardware and/or software modules.

As illustrated schematically in FIGS. 1, 2, 3, 4, 5 and 8, theophthalmological apparatus 1 further comprises an optical transmissionsystem 110 which is configured to transmit the laser pulses P from thelaser source 100 to an optical application device 2. Depending on theembodiment, the optical transmission system 110 is arranged in a(flexible or inherently rigid) support arm 11 which is attached to thebase station 10, as shown in FIGS. 2, 3, 4, for example, and the opticaltransmission system 110 is configured to transmit the laser pulses Pfrom the laser source 100 to the optical application device 2 which isarranged at the end of the support arm 11 averted from the base station10. For example, the support arm 11 is a flexible, articulated supportarm, e.g. an articulated support arm as disclosed in EP 1 731 120 andillustrated in FIGS. 3 and 4, or an inherently rigid support arm, asillustrated in FIG. 2. The optical transmission system 110 comprises oneor more scanning systems having one or more pivotable deflection mirrorsfor scanning a two dimensional (x, y) treatment area in the eye tissue30 with the laser pulses P.

Preferably, the optical application device 2 comprises an opticalprojection system 20 and the optical transmission system 110 isconfigured to transmit the laser pulses P from the laser source 100 tothe optical projection system 20. Different types of optical projectionsystems 20 have different optical characteristics such as focaldistance, refraction power, field of view, and focusing systems 23(described later in more detail), etc. The optical application device 2is further provided with an ophthalmological patient interface device27, which is a fixed, integral part of the optical application device 2or, preferably, attached removeably to the optical application device 2,e.g. to the optical projection system 20.

For removeably attaching the ophthalmological patient interface device27 to the ophthalmological apparatus 1, the optical projection system 20comprises a coupling part 12 configured to attach mechanically theophthalmological patient interface device 27 to the optical projectionsystem 20. Correspondingly, the ophthalmological patient interfacedevice 27 comprises a coupling part 21 configured to attach mechanicallythe ophthalmological patient interface device 27 to the opticalprojection system 20. By mechanically connecting the ophthalmologicalpatient interface device 27 to the optical projection system 20, theophthalmological patient interface device 27 is connected optically tothe optical transmission system 110 and, thus, to the laser source 100.The coupling parts 12, 21 form a coupling system which makes it possibleto connect different types of ophthalmological patient interface devices27 removeably to the ophthalmological apparatus 1 and its opticaltransmission system 110. Depending on the embodiment, for the mechanicalattachment/detachment, the coupling parts 12, 21 form a screw couplingsystem, a bayonet coupling system, a spring latch coupling system, avacuum coupling system, or an electromagnetic force coupling system, forexample.

As is further illustrated schematically in FIGS. 1, 2, 3, 4, 5, 6, 7 and8, the ophthalmological patient interface device 27 comprises at leastone device identifier 22 which is detectable by a detector 13 of theophthalmological apparatus 1.

The device identifier 22 indicates and identifies a particular type ofophthalmological patient interface device 27. Herein, reference is mademerely to one device identifier 22, one skilled in the art willunderstand, however, that depending on the embodiment there are multipleseparate device identifiers 22 or one common device identifier 22 foridentifying the type and various characteristics of the ophthalmologicalpatient interface device 27. For example, the device identifier 22 is amechanical or electrical device identifier 22, integrated in thecoupling part 21 and detectable by a corresponding mechanical orelectrical detector 13, integrated in the coupling part 12 of theoptical projection system 20, respectively. Alternatively, the deviceidentifier 22 is a contactless device identifier 22, e.g. an opticalidentifier or an RFID-identifier, and the detector 13 is a correspondingcontactless detector, e.g. an optical or RFID detector. In the lattercase, the device identifier 22 associated with the ophthalmologicalpatient interface device 27 may be implemented as a unit separate fromthe ophthalmological patient interface device 27, e.g. as part of thepackaging used to protect and sell the ophthalmological patientinterface device 27.

The detector 13 is connected to the control module 14 via a signalinginterface for transmitting to the control module 14 device identifierdata, read or detected on or for the ophthalmological patient interfacedevice 27 currently attached to the optical projection system 20.Accordingly, the device identifier 22 or respective device identifierdata makes it possible for the control module 14 to determine the typeof ophthalmological patient interface device 27 presently attached tothe ophthalmological apparatus 1 or the optical projection system 20,respectively. In an embodiment, the coupling parts 12, 21 are furtherconfigured to establish a signaling interface between theophthalmological apparatus 1 and the ophthalmological patient interfacedevice 27 attached to the optical projection system 20.

The signaling interfaces between the control module 14 and the opticalprojection system 20 or the attached ophthalmological patient interfacedevice 27, respectively, make it possible for the control module 14 totransmit control signals with control data and control commands to theoptical application device 2, specifically to the optical projectionsystem 20 and/or the ophthalmological patient interface device 27, aswill be described later in more detail. Depending on the embodiment, thesignaling interface is contact-based, including wires and electricalcontact elements, or contact-less, including optical or RF connectionmodules.

As is shown in FIGS. 1, 2, 3, 4, 5 and 8, the optical application device2 further comprises a focusing system 23 which is implemented as part ofthe optical projection system 20 or is arranged in the optical pathupstream of the optical projection system 20. As is illustratedschematically in FIGS. 1, 2, 3, 4, 5 and 8, the focusing system 23comprises two optical systems 25, 26, each comprising an arrangement ofone or more optical elements, e.g. one or more lenses and/or mirrors.The optical systems 25, 26 are coupled with a driver system 24,comprising one or more electric motors. The driver system 24 isconfigured to adjust the optical systems 25, 26 individually, eithersequentially or in parallel, such that the laser pulses P are projectedonto a defined projection surface F, e.g. a projection plane, andfocused on this projection surface F with a spot S having a defined spotsize d, as will be described in the following paragraphs with referenceto FIG. 9.

In FIG. 9, reference numerals L′, L*, L refer to pulsed laser beamsshown with their respective beam profiles, e.g. Gaussian beam profiles,at different states of the focusing system 23. Reference numeral L′refers to the pulsed laser beam in a first state where the narrowestsection of the beam profile is projected onto projection surface F′ witha spot size having a diameter d′. Thus, in the first state the pulsedlaser beam L′ is projected onto projection or imaging surface F′. Inthis first state, the beam profile on the upper projection surface F hasa diameter D which is significantly larger than its diameter d′ on theprojection surface F′. Reference numeral L* refers to the pulsed laserbeam in a second state where the narrowest section of the beam profileis projected on projection surface F with a spot size having a diameterd′. Accordingly in this second state, the pulsed laser beam L* isprojected onto projection or imaging surface F. Alternatively, if thefocusing system 23 remains unchanged, the first state of the pulsedlaser beam L′ corresponds to the ophthalmological apparatus 1 havingattached a first type of optical application device 2 and/orophthalmological patient interface device 27; whereas the second stateof the pulsed laser beam L* corresponds to the ophthalmologicalapparatus 1 having attached a different second type of opticalapplication device 2 and/or ophthalmological patient interface device27. Reference numeral L refers to the pulsed laser beam in a third statewhere the narrowest section of the beam profile is projected onprojection surface F with a spot size having a diameter d, which issignificantly smaller than the diameter d′ in the first and secondstates. Thus, in this third state, the pulsed laser beam L is projectedand focused onto projection or imaging surface F with a spot size havinga diameter d. In addition, reference numeral LA refers to the pulsedlaser beam in the third state when the pulsed laser beam is generatedwith a different wavelength, generating on the imaging surface F a spotwith an even smaller spot size having a diameter d″<d. One skilled inthe art will understand that, generally, the imaging surface F islocated in a different position when an alternate wavelength is used.

The control module 14 comprises different zooming functions 140 whichare configured in each case to control the focusing system 23 to projectthe pulsed laser beam L or its laser pulses P, respectively, onto aprojection surface F defined specifically for the respective zoomingfunction 140 (defining a treatment depth), and to focus the pulsed laserbeam L or its laser pulses P, respectively, onto this projection surfaceF with a spot size d (or d′, d″) defined specifically for the respectivezooming function 140 (and a defined intensity profile in the crosssection of the laser beam). As illustrated in FIG. 9, the projectionsurface F is associated with an x/y/z- coordinate system which can bedefined with respect to the ophthalmological apparatus 1, e.g. theoptical projection system 20, or the eye 3. The zooming functions 140are configured to transmit to the focusing system 23 zooming controlsignals via the signaling interface. The zooming functions or zoomingcontrol signals, respectively, control the driver system 24 to adjustthe optical systems 25, 26, either sequentially or in parallel, from aninitial (first, second or other) state to the third state describedabove to project and focus the pulsed laser beam L or the laser pulsesP, respectively, onto the defined projection surface F (at the definedtreatment depth) with the defined spot size d (and intensity profile).Setting different zooming functions makes it possible to adapt flexiblyand efficiently the operation of the ophthalmological apparatus todifferent types of ophthalmological patient interface devices used, forexample, for different treatment procedures. Providing zooming functions140 that control the focusing system 23 to project the pulsed laser beamL or its laser pulses P, respectively, onto a specific definedprojection surface F with a specific defined spot size d (or d′, d″)makes it possible to adapt correctly the projection of the laser beam Lor laser pulses P, respectively, to the typically non-lineartransformation of the optical path through a first configuration, with afirst ophthalmological patient interface device 27 applied on the eyetissue 30, to the optical path through a second configuration, with adifferent second ophthalmological patient interface device 27 applied onthe eye tissue 30.

Specifically, the control module 14 is configured to receive or readfrom the detector 13 the device identifier 22 of the ophthalmologicalpatient interface device 27 currently attached and connected to theoptical projection system 20 or ophthalmological apparatus 1,respectively. The device identifier 22 or corresponding deviceidentifier data, respectively, makes it possible for the control module14 to determine the type of ophthalmological patient interface device27. Depending on the device identifier 22 or type of ophthalmologicalpatient interface device 27, the control module 14 selects and setscontrol parameters, selects and sets modes of operation, and/or selectsand executes control functions, e.g. zooming functions 140. Thus, thecontrol module 14 controls the ophthalmological apparatus 1 based on thedevice identifier 22.

Depending on the configuration and application, selecting differentcontrol parameters, modes of operation and/or control functions includessetting a different wavelength for the laser source 100 and, thus,generating laser pulses P with a different wavelength; setting adifferent projection or imaging surface F and, thus, a differenttreatment area effecting different parts of the eye with different eyetissue 30; and/or setting a different spot size d and, thus, a differenttype of treatment, e.g. precise tissue cuts or coarse tissue disruptionand breakup. In an embodiment, different modes of operation are definedby a respective zooming function 140 and/or a respective wavelength ofthe laser beam L, L′, L*, L1, L2, L3 generated by the laser source 100.For example, the control module is configured to use the deviceidentifier 22 to select and set:

-   -   a first mode of operation for disrupting eye tissue 30 in the        lens of the eye 3 using a first zooming function 140 to focus        laser pulses P having a wavelength in the IR-A-infrared range,    -   a second mode of operation for generating horizontal cuts in the        cornea using a second zooming function 140 to focus laser pulses        P having a wavelength in the UVA-ultraviolet range along a scan        line,    -   a third mode of operation for disrupting eye tissue 20 in the        sclera or clouded cornea using a third zooming function 140 to        focus laser pulses P having a wavelength in the IR-B-infrared        range,    -   a fourth mode of operation for generating cuts in the capsule        using a fourth zooming function 140 to focus laser pulses P        having a wavelength in the UVA-ultraviolet range along a scan        line,    -   a fifth mode of operation for generating vertical cuts in the        cornea using a fifth zooming function 140 to focus laser pulses        P having a wavelength in the IR-A-infrared range, and/or    -   a sixth mode of operation for generating cuts in the lens of the        eye 3 using a sixth zooming function 140 to focus laser pulses P        having a wavelength in the IR-A-infrared range along a scan        line.

In the following paragraphs, various different types of ophthalmologicalpatient interface devices 27 with various different characteristics, asindicated and identified by the device identifier 22, are described withreference to FIGS. 1, 2, 3, 4, 5, 6, 7, and 8. Common to all these typesof the ophthalmological patient interface devices 27 is the feature thatin the applied state of the ophthalmological patient interface devices27 for treating the eye 3, the ophthalmological patient interface device27 is in contact with eye tissue 30. Thus, as illustrated explicitly inFIGS. 1, 5, 6, 7, and 8, the ophthalmological patient interface device27 comprises a contact part 272 with a reference surface 278 which isconfigured and arranged to be in contact with the eye 3, e.g. with thecornea, or a protection foil placed on the eye 3, e.g. on the cornea, inthe applied state of the ophthalmological patient interface device 27during treatment of the eye 3.

Moreover, as illustrated schematically in FIGS. 1, 5, 6, 7, and 8, theophthalmological patient interface device 27 preferably comprisesfastening means 271, e.g. a fastening element such as a suction ring orsuction ring segments, for fastening the ophthalmological patientinterface device 27 to the eye 3, e.g. to a ring-shaped surface are A ofthe eye 3, as illustrated in top view T of the cornea in FIG. 5.

As illustrated schematically in FIGS. 1, 2, 3 and 4, one type of theophthalmological patient interface device 27 comprises a contact bodywith a reference surface 278 configured to place at least part of thecornea into a defined position with respect to the optical projectionsystem 20, when the ophthalmological patient interface device 27 iscoupled to the optical projection system 20 and applied on the corneafor the treatment of the eye 3. Depending on the shape of the contactbody, the cornea is applanated by the contact body or given anotherdesired shape, for example concave or convex. Moreover, theophthalmological patient interface device 27 or the contact body,respectively, has a receiving surface 277 which is averted from thereference surface 278 and faces the optical projection system 20 whenthe ophthalmological patient interface device 27 is coupled to theoptical projection system 20.

For this type of ophthalmological patient interface device 27, thedevice identifier 22 indicates interface characteristics such asthickness (in the direction of the projection axis of the opticalprojection system 20 between the reference surface 278 and the receivingsurface 277), material, refraction index, shape, e.g. plane or curved(spherically, convexly), etc. Further characteristics indicated by thedevice identifier 22 include the presence and arrangement of integralparts of the contact body, e.g. mirror elements or other opticalelements as described later in more detail in the context of FIGS. 7 and8.

As illustrated schematically in FIGS. 5, 6, 7 and 8, another type of theophthalmological patient interface device 27 comprises a ring-shapedcontact part 272 which is either a continuous non-interrupted ring or aring composed of several ring segments which are separated by gapsbetween two adjacent ring segments. The ring-shaped contact part 272 hasa reference surface 278 which is in contact with a ring-shaped,peripheral surface area of eye tissue 30, e.g. a ring shaped, peripheralsurface area B of the cornea as shown in top view T of the cornea inFIG. 5, when the ophthalmological patient interface device 27 is appliedfor the treatment of the eye 3, while leaving uncovered by the contactpart 272 an inner, round, central surface area of eye tissue 30, e.g. aninner, round, central surface area C of the cornea as shown in top viewT of the cornea in FIG. 5, which is surrounded by the coveredring-shaped surface area B. The reference surface 278 is arranged andshaped to place the ring-shaped surface area B contacted by the contactpart 272 into a defined position with respect to the optical projectionsystem 20 when the ophthalmological patient interface device 27 iscoupled to the optical projection system 20 and applied for thetreatment of the eye 3. Averted from the reference surface 278, thecontact part 272 comprises a receiving surface 277 which faces theoptical projection system 20 when the ophthalmological patient interfacedevice 27 is coupled to the optical projection system 20. Thering-shaped contact part 272 is made from a firm and transparentmaterial and configured to let pass a laser beam L, L′, L*, L1, L2, L3from the optical projection system 20 through the contact part 272 intothe eye tissue 30, e.g. into the cornea. Thus, as illustrated in FIG. 5,a laser beam L1 directed into eye tissue 30 covered by the ring-shapedsurface area B will travel from the optical projection system 20 throughthe receiving surface 277 and subsequently through the reference surface278 into the eye tissue 30. In an embodiment, the ring-shaped contactpart 272 is configured to focus the laser beam L1 into the eye tissue30. For example, for focusing the laser beam L1, the ring-shaped contactpart 272 comprises diffractive optical elements. On the other hand, alaser beam L2 directed into eye tissue 30 covered by the round centralsurface area C will travel from the optical projection system 20 intothe eye tissue 30, e.g. the lens, without passing through the contactpart 272. The advantage of this configuration is that the centralsurface area C of the cornea or the central part of the cornea,respectively, is left uncovered by the ophthalmological patientinterface device 27 and is thus mechanically undisturbed. Therefore, inthe central part of the cornea, there will be no occurrence of sideeffects, such as corneal folds, that disturb the focus behind theposterior surface of the cornea. Thus, in eye tissue 30 below thecentral part of the cornea, focusing deep into the eye 3 is possible,without disturbance of the focus. On the other hand, the position of theperipheral surface area B of the cornea or the peripheral part of thecornea, respectively, is well defined by the ring-shaped contact part272, making possible cuts of precise dimensions, without requiring animaging system for precisely guiding the focus.

As further illustrated in FIGS. 5, 6, 7, and 8, the ophthalmologicalpatient interface device 27 comprises a wall 274, e.g. of ring orcylindrical shape, which extends from the contact part 272 to thecoupling part 21 and encompasses a hollow space 276. In a variant, thewall 274 has an inlet 273 for filling a liquid or gel into the hollowspace 276 when the ophthalmological patient interface device 27 isapplied for the treatment of the eye 3, and the wall 274 is alsoprovided with one or more venting outlets.

As shown in FIGS. 5, 6, 7, and 8, the wall 274 is attached and arrangedon the reference surface 278 such that at least part of the referencesurface 278 is exposed to and borders onto the hollow space 276.Specifically, the reference surface 278 is arranged such that it isaccessible directly by a laser beam L, L′, L*, L1, L2, L3 when theophthalmological patient interface device 27 is coupled to the opticalprojection system 20. Accordingly, as shown in FIG. 5, a laser beam L1directed into eye tissue 30 covered by the ring-shaped surface area Bwill travel from the optical projection system 20 through the empty orliquid filled hollow space 276, through the receiving surface 277, andsubsequently through the reference surface 278 into the eye tissue 30.On the other hand, a laser beam L2 directed into eye tissue 30 coveredby the round central surface area C will travel from the opticalprojection system 20 through the empty or liquid filled hollow space 276into the eye tissue 30, e.g. the lens, without passing through thecontact part 272.

For the ophthalmological patient interface device 27 illustrated inFIGS. 5, 6, 7, and 8, the device identifier 22 indicates furtherinterface characteristics such as dimensions, shape, location, material,and/or refraction index of the contact part 272; size, shape and/orlocation of the opening defined by the contact part 272; and/or shapeand/or dimensions of the hollow space 276 defined by the wall 274.

As illustrated in FIGS. 7 and 8, a further type of the ophthalmologicalpatient interface device 27 comprises a mirror system 275 including atleast one mirror 28, 29. The mirror system 275 is arranged downstreamfrom the optical projection system 20 in the hollow space 276, when theophthalmological patient interface device 27 is attached to the opticalprojection system 20. The mirror system 275 or its mirrors 28, 29,respectively, are attached to the ophthalmological patient interfacedevice 27, for example by way of supporting elements connected to thewall 274 or the coupling part 21. In an alternative embodiment, themirror system 274 or its mirrors 28, 29, respectively, are attached tothe optical projection system 20, fixed or removeably, and inserted intothe hollow space 276 when the ophthalmological patient interface device27 is attached to the optical projection system 20. In a furtherembodiment, the mirror system is integrated in the contact body of theophthalmological patient interface device 27 described above in thecontext of FIGS. 1, 2, 3, and 4. The mirror system 275 has at least onemirror 28, 29 or mirroring surface arranged at an angle with respect toa projection axis of the optical projection system 20 such that a laserbeam L3 projected by the optical projection system 20 is deflected bythe mirror system 275 away from the projection axis.

In the embodiment shown in FIGS. 7 and 8, the mirror system 275comprises more than one mirror 28, 29 which are arranged in sequencesuch that the laser beam L3 projected by the optical projection system20 is guided by the mirror system 275 to impinge the eye tissue 30 at adifferent angle than the projection axis and/or at a different locationthan the projection axis.

In an embodiment, the mirror system 275 comprises at least one mirror28, 29 or mirroring surface which is rotatable about the projection axisof the optical projection system 20, e.g. manually or by way of amovement driver, such as an electric motor. In another embodiment, themirror system 275 comprises at least one mirror 28, 29 with anadjustable deflection angle, e.g. manually or by way of a movementdriver, such as an electric motor. In a further embodiment, the mirrorsystem 275 comprises at least one mirror 28, 29 which is adjustable witha translatory movement to expand the working area in lateral direction.In case of motorized mirrors 28, 29, the control module 14 is furtherconfigured to control the rotational position, lateral position throughtranslatory movement, and/or deflection angle, respectively, of themirrors 28, 29 via the signaling interface.

Preferably, the sequentially arranged mirrors 28, 29 of the mirrorsystem 275 are adjusted or adjustable to guide the laser beam L3projected by the optical projection system 20 behind selected structuresof the eye 3 without traversing the selected structures of the eye 3.For example, the mirror system 275 is configured or configurable toguide the laser beam L3 behind the Iris, the anterior chamber angle, thelimbus, or the sclera, etc.

Arranging a mirror system 275 downstream from the optical projectionsystem 20 makes it possible to extend flexibly and easily the treatmentarea of the ophthalmological apparatus 1 or add new treatmentprocedures, respectively, which would otherwise not be possible withconventional configurations.

For the of ophthalmological patient interface device 27 illustrated inFIGS. 7 and 8, the device identifier 22 indicates further interfacecharacteristics such as the presence and configuration of the mirrorsystem 275, including the number, location, size, and/or angulararrangement of its mirror(s) 28, 29 or other optical element(s).

In an embodiment, the wall 274 is attached to the ophthalmologicalapparatus 1 and extends from the optical projection system 20 to thecoupling part 12. In this embodiment, the mirror system is attached tothe ophthalmological apparatus 1 and arranged at least partly in thehollow space formed by the wall 274.

For the types of the ophthalmological patient interface device 27 thatcomprise a mirror system 275 which deflects the laser beam L3 from theoptical projection system 20 away from the projection axis, the controlmodule 14 comprises further zooming functions 140 which are configuredto control the focusing system 23 depending on the current deviceidentifier 22 or corresponding device identifier data, respectively, notonly for a specific treatment depth (z-direction corresponding to theprojection axis of the optical projection system 20) at the respectiveprojection surface F, as described above with reference to FIG. 9, butalso for a specific treatment location in the lateral x/y-direction,i.e. normal to the projection axis of the optical projection system 20.

1. An ophthalmological patient interface device for application onto aneye during treatment of the eye, the ophthalmological patient interfacedevice comprising: a coupling part configured to attach mechanically theophthalmological patient interface device to an optical projectionsystem of an ophthalmological apparatus, a fastening element configuredto fasten the ophthalmological patient interface device to the eye, anda mirror system arranged downstream from the optical projection system,when the ophthalmological patient interface device is attachedmechanically to the optical projection system, and having at least onemirroring surface arranged at an angle with respect to a projection axisof the optical projection system such that a laser beam projected by theoptical projection system is deflected by the mirror system.
 2. Theophthalmological patient interface device of claim 1, wherein the mirrorsystem comprises more than one mirror which are arranged in a sequencesuch that the laser beam projected by the optical projection system isguided by the mirror system to impinge the eye tissue at a differentangle than the projection axis of the optical projection system.
 3. Theophthalmological patient interface device of one of claim 1, wherein themirror system comprises more than one mirror which are arranged in asequence such that the laser beam projected by the optical projectionsystem is guided by the mirror system to impinge the eye tissue at adifferent location than the projection axis of the optical projectionsystem.
 4. The ophthalmological patient interface device of one ofclaims 1, wherein the mirror system comprises at least one mirroringsurface which is rotatable about the projection axis of the opticalprojection system.
 5. The ophthalmological patient interface device ofone of claim 1, wherein the mirror system comprises at least one mirrorwith an adjustable deflection angle.
 6. The ophthalmological patientinterface device of one of claim 1, wherein the mirror system comprisesmore than one mirror which are arranged in a sequence such that thelaser beam projected by the optical projection system is guided by themirror system behind selected structures of the eye without traversingthe selected structures of the eye, the selected structures of the eyeincluding at least one of: Iris, anterior space, limbus, and sclera. 7.The ophthalmological patient interface device of one of claim 1, furthercomprising a wall extending from the fastening element to the couplingpart and encompassing a hollow space, the mirror system being arrangedin the hollow space.
 8. An ophthalmological apparatus comprising: anoptical projection system for projecting a laser beam into eye tissuefor treatment of the eye, a coupling part configured to attachmechanically the optical projection system to an ophthalmologicalpatient interface device configured to fasten the optical projectionsystem to the eye, and a mirror system attached to the opticalprojection system and arranged downstream from the optical projectionsystem, and having at least one mirroring surface arranged at an anglewith respect to a projection axis of the optical projection system suchthat the laser beam projected by the optical projection system isdeflected by the mirror system.
 9. The ophthalmological apparatus ofclaim 8, wherein the mirror system is arranged at least partly in anopening of the ophthalmological patient interface device, when theophthalmological patient interface device is attached mechanically tothe optical projection system.
 10. The ophthalmological apparatus of oneof claim 8, wherein the mirror system comprises more than one mirrorwhich are arranged in a sequence such that the laser beam projected bythe optical projection system is guided by the mirror system to impingethe eye tissue at a different angle than the projection axis of theoptical projection system.
 11. The ophthalmological apparatus of one ofclaim 8, wherein the mirror system comprises more than one mirror whichare arranged in a sequence such that the laser beam projected by theoptical projection system is guided by the mirror system to impinge theeye tissue at a different location than the projection axis of theoptical projection system.
 12. The ophthalmological apparatus of one ofclaim 8, wherein the mirror system comprises at least one mirroringsurface which is rotatable about the projection axis of the opticalprojection system.
 13. The ophthalmological apparatus of one of claim 8,wherein the mirror system comprises at least one mirror with anadjustable deflection angle.
 14. The ophthalmological apparatus of oneof claim 8, wherein the mirror system comprises more than one mirrorwhich are arranged in a sequence such that the laser beam projected bythe optical projection system is guided by the mirror system behindselected structures of the eye without traversing the selectedstructures of the eye, the selected structures of the eye including atleast one of: Iris, anterior space, limbus, and sclera.
 15. Theophthalmological apparatus of one of claim 8, further comprising a wallextending from the optical projection system to the coupling part andencompassing a hollow space, the mirror system being arranged at leastpartly in the hollow space.